Adjustable orthopedic connections

ABSTRACT

The disclosure includes methods and systems for making orthopedic connections where there is unique adjustability to the connection. Illustratively, one embodiment provides a connecting assembly for connecting a plurality of orthopedic components. Such connecting assemblies can include a first orthopedic component that provides a female bore. Additionally, the assembly can include a second orthopedic component that can be or include a male-type connecting member that is positionable in the bore of the first orthopedic component. In one preferred form, the male-type connecting member will be a quasi-spherical member. The quasi-spherical member can include a textured outer surface, e.g., for contacting one or more walls or surfaces in the bore in a fashion that removably locks or helps to removably lock or fix the quasi-spherical member in the bore.

CLAIM OF PRIORITY

This patent application is a continuation of U.S. patent applicationSer. No. 15/863,223, filed on Jan. 5, 2018, which claims the benefit ofpriority, under 35 U.S.C. Section 119(e), to NATHAN WINSLOW et al., U.S.Patent Application Ser. No. 62/444,142, entitled “ADJUSTABLE ORTHOPEDICCONNECTIONS,” filed on Jan. 9, 2017, each of which is herebyincorporated by reference herein in its entirety.

TECHNICAL FIELD

The present disclosure relates generally to medical technology and incertain aspects to methods and systems for adjustably connectingorthopedic components, e.g., an articulating member to a stem or base.

BACKGROUND

As further background, the head or other portions of a proximal humeruscan be replaced with prosthetic devices, e.g., to treat advanceddegeneration of the proximal humerus. Due to the variability of theanatomy, e.g., head height, diameter, inclination and offset to thehumeral canal, effective anatomical reconstruction can often necessitatea modular system offering a variety of implant configurations.

OVERVIEW

The present disclosure provides, in certain aspects, unique methods andsystems for integrating or connecting orthopedic components.Illustratively, one aspect of the present disclosure provides aconnecting assembly for connecting a plurality of orthopedic components.This particular connecting assembly includes a first orthopediccomponent that provides a bore. The assembly also includes a secondorthopedic component that can be or include a quasi-spherical memberthat is positionable in the bore of the first orthopedic component forremovably locking the quasi-spherical member to the first orthopediccomponent. The quasi-spherical member includes a textured outer surfacesuch as any of those disclosed herein. The textured outer surface cancontact walls of the bore in a manner that removably locks or helps toremovably lock the quasi-spherical member to the first orthopediccomponent. While not necessary, any suitable combination of thefollowing features can be incorporated into or associated with theconnecting assembly. The quasi-spherical member can be part of a bonescrew or fastener. Such a bone screw can include a shaft (e.g., a fullyor partially threaded shaft with or without one or more tapered and/orone or more non-tapered longitudinal sections) that extends away fromthe quasi-spherical member, for example, where the quasi-sphericalmember forms all or part of a head of the screw. The orthopediccomponent can be an implant. The orthopedic component can be a boneplate. With a bone plate, the bore can extend partially or entirelythrough a wall of the plate. In some forms, a bore will extend entirelythrough a wall of the plate and a leading tip of the screw will bepassed through the bore in advance of the quasi-spherical member. Thefirst orthopedic component can be an articulating ball or head membersuch as a humeral head. The quasi-spherical member can be a modularcomponent that is connectable to a separate humeral stem component. Thetextured outer surface can cover a significant portion of thequasi-spherical member such as more than 25% or more than 50%. Thetextured outer surface can include a plurality of planar surfaceelements, e.g., with polygonal perimeters.

In one aspect, the present disclosure provides a ball-side prosthesisfor articulating with a socket in a ball and socket joint in a patient.This particular prosthesis comprises an articulating ball member thatincludes a top side and a bottom side. The top side provides a convexarticulating surface for articulating with surfaces in the socket. Thebottom side includes an opening into a bore that extends into thearticulating ball member from the bottom side toward the top side. Theprosthesis further comprises a fixation member that is anchorable to abone of the patient remaining on the ball side of the ball and socketjoint. The prosthesis further comprises a quasi-spherical member that isdisposed at a proximal end of the fixation member. The quasi-sphericalmember is positionable in the bore of the articulating ball member forremovably locking the quasi-spherical member to the articulating ballmember. The quasi-spherical member includes a textured outer surfacesuch as any of those disclosed herein for contacting walls of the bore.While not necessary, any suitable combination of the following featurescan be incorporated into or associated with the prosthesis. The fixationmember can include an elongate stem that is receivable in anintramedullary canal on the ball side of the ball and socket joint. Thearticulating ball member can be a humeral head. The bore can include atapered segment. The fixation member and the quasi-spherical member canbe modular components that are connectable to one another, e.g., using aMorse-type taper connection. The textured outer surface can cover anysuitable percentage of the quasi-spherical member, e.g., between about10% and 100%, or between about 40% and about 99%, or between about 50%and about 90%. The textured outer surface can include a plurality ofgenerally planar faces, e.g., including generally planar faces spacedfrom one another on the quasi-spherical member and/or includinggenerally planar faces contiguous with one another on thequasi-spherical member. The textured outer surface can include aplurality of surface elements with polygonal perimeters, e.g., includingsurface elements with planar surfaces within the polygonal perimetersand/or including surface elements with convex and/or concave surfaceswithin the polygonal perimeters. The textured outer surface can includea three-dimensional tessellation incorporating polygonal surfaces. Thequasi-spherical member can approximate a honeycomb of polyhedral cells.

In one aspect, the present disclosure provides a quasi-spherical memberthat is positionable in the bore of an orthopedic component forremovably locking the quasi-spherical member to the orthopediccomponent. The quasi-spherical member comprises a textured outer surfacethat includes a plurality of outermost extensions that are spaced fromone another on the textured outer surface and which define a firstradius of the quasi-spherical member and a plurality of innermostdepressions that are spaced from one another on the textured outersurface and which define a second radius of the quasi-spherical member.The textured outer surface can contact walls of the bore in a mannerthat removably locks or helps to removably lock the quasi-sphericalmember to the orthopedic component. While not necessary, any suitablecombination of the following features can be incorporated into orassociated with the quasi-spherical member or orthopedic component. Thebore can include a tapered segment with a first diameter that is twicethe first radius and a second diameter that is twice the second radius.The plurality of innermost depressions can occur on planar and/ornon-planar (e.g., concave) surfaces on the quasi-spherical member. Theplurality of outermost extensions can be symmetrical peaks on thequasi-spherical member.

In one aspect, the present disclosure provides a humeral prosthesis forarticulating with a glenoid cavity in a patient. This particular humeralprosthesis comprises a humeral head member that includes a top side anda bottom side. The top side provides a convex articulating surface forarticulating with surfaces in the glenoid cavity, e.g., a native glenoidcavity. The bottom side includes an opening into a bore that extendsinto the humeral head member from the bottom side toward the top side.The prosthesis further includes a fixation member that is anchorable toa humerus of the patient. The prosthesis further includes aquasi-spherical member that is disposed at a proximal end of thefixation member, e.g., where the quasi-spherical member is an integralpart of the fixation member. The quasi-spherical member is positionablein the bore of the humeral head member for removably locking thequasi-spherical member to the humeral head member. The quasi-sphericalmember includes a textured outer surface such as any of those disclosedherein for contacting walls of the bore. In one embodiment, the texturedouter surface includes a plurality of outermost extensions that arespaced from one another on the textured outer surface and which define afirst radius of the quasi-spherical member and a plurality of innermostdepressions that are spaced from one another on the textured outersurface and which define a second radius of the quasi-spherical member.While not necessary, the fixation member can include an elongate stemthat is receivable in an intramedullary canal on the ball side of theball and socket joint and/or the textured outer surface can include athree-dimensional tessellation of triangular surfaces whose verticesprovide the plurality of outermost extensions.

In some aspects, the present disclosure provides systems and methodsthat can be used in a humeral reconstruction surgery in which the heador proximal end of the humerus bone is replaced or repaired, e.g.,providing surgeons with modular humeral head systems offering rapid andaccurate adjustability. In some forms, modular humeral heads will haveeccentric centers and/or be used with stemmed or stemless humeralfixation members.

Some aspects of the present disclosure involve connections between afemale-type bore in a first orthopedic member such as an orthopedicplate (e.g., a bone plate) and a quasi-spherical member or anothermale-type connector of a second orthopedic member. This second membercan be any orthopedic element or device to be connected to the plate. Incertain embodiments, this second member will be something to be driveninto or otherwise received in bone, for example, to attach the plate toa bone. This second member can be a screw, fastener, pin, spike, ornail. For example, the second member can be a screw with a taperedshaft, or having a significant longitudinal section of the shaft beingtapered with or without threading. In some embodiments, the firstorthopedic member will be a non-plate orthopedic device. In someembodiments, the first orthopedic member will be an orthopedic implant(e.g., a knee, hip, shoulder, ankle, or another joint implant).

Some aspects of the present disclosure involve devices/systems/methodsrelating to a reverse shoulder arthroplasty. A traditional shoulderjoint implantation may require that the rotator cuff muscles be presentand function normally. When this is not the case, a reverse shoulderprosthesis may be preferable. In the reverse shoulder prosthesis, ahumeral implant prosthesis can include a fixation member, a humeral trayconnected to the fixation member, and an articulating liner retained inthe humeral tray. A glenoid component can support a head member whichcan articulate with the articulating liner when the humerus bone moves.

The humeral tray can include a top surface for receiving thearticulating liner. The humeral tray can include a bottom surface thatcan include a tray stern having a quasi-spherical member locatedadjacent the end of the tray stem. The quasi-spherical member caninclude a textured surface as described above. The quasi-sphericalmember can be located in a bore at the proximal end of the fixationmember. A surgeon can modify an orientation of the humeral tray by thevariable positioning of the quasi-spherical member in the bore. Once thedesired orientation is located, the quasi-spherical member can be lockedinto place. This can allow the surgeon to provide a more accurate fit ofthe humeral prosthesis to an individual's anatomy.

Various types of implant components have been used indevices/systems/methods relating to shoulder implant assemblies,including reverse and traditional shoulder arthroplasty. Examples ofthese devices/systems/methods are illustrated and described in U.S. Pat.Nos. 6,942,699; 7,175,663; 7,241,314; 7,753,959; 7,918,895; 8,246,687;and 8,317,871. Each of these patents is incorporated by reference as iffully set forth herein.

Each of these non-limiting examples can stand on its own or can becombined in various permutations or combinations with one or more of theother examples.

BRIEF DESCRIPTION OF THE DRAWINGS

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate exemplary embodiments of the invention, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner. In the drawings, which are not necessarilydrawn to scale, like numerals may describe similar components indifferent views. Like numerals having different letter suffixes mayrepresent different instances of similar components. The drawingsillustrate generally, by way of example, but not by way of limitation,various embodiments discussed in the present document.

FIG. 1A shows a humeral prosthesis according to one embodiment of thepresent disclosure.

FIG. 1B shows an alternative orientation of the humeral prosthesis ofFIG. 1A.

FIG. 1C shows a radiographic image of an illustrative humeralprosthesis.

FIG. 2 shows a humeral head member according to one embodiment of thepresent disclosure.

FIG. 3A shows a side, cross-sectional view of a humeral head memberaccording to one embodiment of the present disclosure.

FIG. 3B illustrates a radius of a perfect sphere.

FIG. 3C shows a quasi-spherical member with a textured outer surfaceaccording to one embodiment of the present disclosure.

FIGS. 4A-4D show quasi-spherical members with textured outer surfaces ofdifferent densities according to additional embodiments of the presentdisclosure.

FIG. 5A shows a quasi-spherical member with a textured outer surfaceaccording to one embodiment of the present disclosure.

FIG. 5B shows a quasi-ellipsoid member with a textured outer surfaceaccording to one embodiment of the present disclosure.

FIG. 6A shows a quasi-spherical member with a textured outer surfaceaccording to one embodiment of the present disclosure.

FIG. 6B shows a quasi-spherical member with a textured outer surfaceaccording to one embodiment of the present disclosure.

FIG. 7A shows a humeral member according to one embodiment of thepresent disclosure.

FIG. 7B shows a humeral member according to another embodiment of thepresent disclosure.

FIG. 8 shows a humeral member according to one embodiment of the presentdisclosure.

FIG. 9 shows a humeral member according to another embodiment of thepresent disclosure.

FIG. 10 shows a front view of a bone screw according to one embodimentof the present disclosure.

FIG. 11 shows a front view of an orthopedic assembly according to oneembodiment of the present disclosure.

FIG. 12 shows a front view of an orthopedic assembly according toanother embodiment of the present disclosure.

FIG. 13A shows a top view of an orthopedic plate according to oneembodiment of the present disclosure.

FIG. 13B is a cross-sectional view taken along view line 13B-13B fromFIG. 13A.

FIG. 13C shows part of an orthopedic plate according to anotherembodiment of the present disclosure.

FIG. 14 shows an implant assembly for a total shoulder jointreplacement, according to at least one embodiment of the presentdisclosure.

FIG. 15 shows a perspective view of a humeral tray assembly. accordingto at least one embodiment of the present disclosure.

FIG. 16 shows a cross-section of a humeral tray assembly, according toat least one embodiment of the present disclosure.

FIG. 17 shows a cross-section of a tray engaged with a fixture member,according to at least one embodiment of the present disclosure.

FIG. 18 shows a cross-section of a tray engaged with a fixture member,according to at least one embodiment of the present disclosure.

FIG. 19 shows a cross-section of a tray engaged with a fixture member,according to at least one embodiment of the present disclosure.

FIG. 20 shows a cross-section of a tray engaged with a fixture member,according to at least one embodiment of the present disclosure.

FIG. 21 shows a humeral tray assembly having an internal bore, accordingto at least one embodiment of the present disclosure.

FIG. 22 illustrates an implant assembly for a total shoulder jointreplacement, according to at least one embodiment of the presentdisclosure.

FIG. 23 illustrates an implant assembly for a total shoulder jointreplacement having a secondary locking system, according to at least oneembodiment of the present disclosure.

FIG. 24 illustrates an implant assembly for a total shoulder jointreplacement having a secondary locking system, according to at least oneembodiment of the present disclosure.

FIG. 25 illustrates an implant assembly for a total shoulder jointreplacement having a secondary locking system, according to at least oneembodiment of the present disclosure.

FIG. 26 illustrates an implant assembly for a total shoulder jointreplacement having a secondary locking system, according to at least oneembodiment of the present disclosure.

DETAILED DESCRIPTION

As disclosed above, the present disclosure provides, in certain aspects,unique methods and systems for making orthopedic connections.Illustratively, some embodiments of the present disclosure provide aconnecting assembly for connecting a plurality of orthopedic components,e.g., where the connecting assembly itself provides a unique way tospatially adjust a first component relative to a second component. Suchconnecting assemblies can include a first orthopedic component thatprovides a female bore. Additionally, the assembly can include a secondorthopedic component that can be or include a male-type connectingmember that is positionable in the bore of the first orthopediccomponent. In one preferred form, the male-type connecting member willinclude a quasi-spherical member. The quasi-spherical member includes atextured outer surface, e.g., for contacting one or more walls orsurfaces in the bore in a fashion that removably locks or helps toremovably lock or fix the quasi-spherical member in the bore. Othersuitable male-type connecting members incorporating textured outersurfaces in accordance with the present disclosure can approximate othershapes (e.g., non-spherical shapes such as a quasi-ellipsoid shape) asdiscussed elsewhere herein. In some preferred embodiments, the geometryof the textured outer surface will allow the quasi-spherical member tobe positioned and locked in the bore in a rather large number oforientations or angular positions, for example, to account forvariability in the patient's anatomy. In some instances, such aconnecting assembly will be part of a ball-side prosthesis forarticulating with a socket in a ball and socket joint in a patient. Forexample, the first orthopedic component can be an articulating ballmember such as a humeral head member that includes a top side and abottom side. The top side can provide a convex articulating surface forarticulating with surfaces in the socket. The bottom side can include anopening into the bore, e.g., extending into the articulating ball memberfrom the bottom side toward the top side. The quasi-spherical member canbe disposed at the proximal end of a fixation member that is anchorableto a bone of the patient remaining on the ball side of the ball andsocket joint. In the context of a humeral prosthesis, for example, theorientation or angular position of the quasi-spherical member in thebore can be adjusted to account for variability in things like headheight, diameter, inclination and offset to the humeral canal. In someembodiments, the first orthopedic component is a bone plate, and thesecond orthopedic component is a bone screw such as where a leading tipof a shaft of the screw is passed through the plate through the femalebore and into bone in advance of a quasi-spherical member that formspart of the screw, e.g., forming all or part of a head of the screw.Thereafter, the quasi-spherical member can be received and locked in thebore in a rather large number of orientations or angular positions forattaching the plate to bone, for example, by advancing the screw to adesired final location in the bone. Such connections can be effective toresist back-out of the screw. In some instances, a shaft or a leadingtip of a shaft never passes through a female bore in a plate. In someembodiments, a leading tip of the shaft enters bone before the screwcontacts or is associated with the plate. In some forms, a screw isadvanced to a desired final location in the bone before thequasi-spherical member is locked in the female bore, for example, wherea plate is impacted down onto a pre-positioned screw so that thequasi-spherical member is forcefully received and locked in the femalebore.

In some embodiments, the first component can be a fixation member thatcan be inserted into a humerus bone of a patient. The fixation membercan define a bore near its proximal end. In some embodiments, the secondcomponent can be a humeral tray member. The humeral tray member caninclude a tray stem extending from the back surface of the tray. Thedistal end of the stem can include a quasi-spherical member. A surgeoncan adjust the position of the tray relative to the fixation member andlock the quasi-spherical member into the bore when the desiredorientation is achieved.

FIGS. 1A-1B show an illustrative humeral prosthesis 10. This particularhumeral prosthesis 10 can include a humeral head member 40 and anassembly 9. The assembly 9 can include a quasi-spherical member 20, anda humeral fixation member 60. The humeral head member 40 includes a topside 41 and a bottom side 42. The humeral head member 40 can behemispherical or partially-spherical in shape and, in this particularinstance, the top side 41 provides a convex articulating surface 47 forarticulating with glenoid surfaces, e.g., natural or synthetic matingglenoid surfaces of a human or animal shoulder. The humeral head member40 can be formed with any suitable material including metals, ceramics,polymers or combinations of these materials. The humeral fixation member60 is anchorable to a humerus. The humeral fixation member 60 includes astem 70 which is sized and shaped to be inserted into a canal 73 of thehumerus 74 (See FIG. 1C). The stem 70 can be anchored in any suitablemanner such as being cemented, non-cemented, pinned, or screwed to thesurrounding bone material and can be configured to promote boneingrowth. The stem 70 can be formed with any suitable material includingmetals, ceramics, polymers or combinations of these materials. FIG. 1Cis a radiographic image of a humeral prosthesis implanted after anillustrative shoulder replacement surgery. The stem 70 of the fixationmember 60 can be installed in the canal 73 of a humerus bone 74. Thehumeral head member (head) 40 can be located at the proximal end 59 ofthe humerus 74 and can articulate with natural or synthetic matingglenoid surfaces 58 of the shoulder 75.

Referring to FIGS. 1A-1B, during a shoulder replacement in which ahumeral prosthesis 10 is required and perhaps owing to variations inanatomy, a surgeon may elect to adjust the orientation or angularposition of a humeral head 40 (shown in cross-section) relative to aremaining anatomical structure or another implant component such ashumeral fixation member 60. The humeral head member 40 includes a bottomside 42 that provides a bore 43 with one or more walls 44. The boreextends into the humeral head member from the bottom side toward the topside. The bore 43 can be tapered with the opening wider at the bottomside 42 and narrowing towards a base 48 forming a bottom of the bore 43.A suitable female bore can be tapered or non-tapered. A suitablefemale-type bore can be or incorporate any suitable three-dimensionalshape, e.g., incorporating rectilinear and/or curvilinear features. Asuitable female-type bore can have a frustoconical shape. Suitableshapes of a female-type bore can be or include full and partial forms ofwedges, tapered bodies, toroids, conoids, catenoids, cubes,parallelepipeds, prisms, and combinations of the same. Suitable shapesinclude but are not limited to full or partial cylinders, cuboids,cones, pyramids, and tetrahedrons, and combinations of the same, and inthis regard, it will be understood that male-type connectorsincorporating textured outer surfaces in accordance with certain aspectsof the present disclosure can approximate any suitable shape as well.Thus, in addition to spheres, such male-type connecting members canapproximate non-spherical shapes, e.g., incorporating any suitablethree-dimensional rectilinear and/or curvilinear shape. Illustratively,in some preferred forms, a male-type connector incorporating a texturedouter surface in accordance with the present disclosure will approximateall or part of a shape like a sphere (e.g., a partial sphere such as ahemisphere), ellipsoid, oblate spheroid, prolate spheroid, catenoid,conoid, or paraboloid of revolution,

Continuing with FIGS. 1A-B, contact between the quasi-spherical member20 and walls 44 of the bore at one or more interfaces 22 can allow asurgeon to orient the humeral head 40 in a wide range of positions, twoof which can be seen in the different angles of the humeral head 40illustrated in FIGS. 1A and 1B. FIG. 1A shows the relationship betweenthe fixation member 60 and the humeral head 40 at a first angle 17 andFIG. 1B shows the relationship between the fixation member 60 and thehumeral head 40 at a second angle 18. The geometry of thequasi-spherical member 20 can allow these angular adjustments to be madein three dimensions. During an evaluation of the orientation or angularposition of the humeral head 40, the quasi-spherical member 20 may beonly partially inserted into the bore 43. Even then, there may besufficient grip to hold the components together to allow the surgeon tojudge the suitability of the positioning. Once the humeral head 40 isdeemed by a surgeon to be suitably oriented, the quasi-spherical member20 can then be more fully inserted into the bore 43, e.g., by impactionloading accomplished by pressure, impact force or otherwise. In someinstances, forcible contact between a male-type member such asquasi-spherical member 20 and walls of the bore will be sufficient tocrush or to otherwise deform surface features of the male-type memberand/or surfaces or walls within the female bore. The shape of the bore43 including its walls 44 and the shape and surface features of thequasi-spherical member 20 can be such that the quasi-spherical membercan be positionable in the bore of the humeral head member for removablylocking the quasi-spherical member to the humeral head member, e.g.,providing a fixed immovable connection between the quasi-sphericalmember 20 and the humeral head 40.

The quasi-spherical member 20 is disposed at a proximal end of thefixation member 60. In this particular embodiment, the humeralprosthesis 10 can include a narrowing and connecting member 37 which canform a transition between the quasi-spherical member 20 and the fixationmember 60. This connecting member 37 can be sized and shaped to provideclearance for adjustment of the humeral head 40 on the quasi-sphericalmember 20. The humeral head 40 can include a cannulation 55 providing anopening extending from the base 48 of the bore 43 to the convexarticulating surface 47. The cannulation 55 can be used for insertion ofa pin-like tool (not pictured) to separate the humeral head 40 from thequasi-spherical member 20 after the two members have been fixedlyattached by impact loading. In another example, the cannulation 55 canbe threaded to use in conjunction with a bolt (not pictured) to separatethe humeral head member 40 from the quasi-spherical member 20. Althoughthe bore 43 is illustrated as positioned on a center axis 39 of thehumeral head 40, the placement of the bore 43 can be offset from thecenter axis 39 to provide a surgeon with additional configurations forthe humeral prosthesis 10.

FIG. 2 shows a perspective view of another example of a humeral headmember 40. The bottom side 42 can include a recessed area 49 which canprovide a humeral head member 40 with a lighter weight and/or greaterorientation adjustment.

FIG. 3A shows a cross-section of a humeral head 40. The bore 43 can betapered to include a first radius 45 positioned near the bottom side 42and a second radius 46 positioned near the base 48. While not necessary,the first radius 45 and the second radius 46 can be related tomeasurements on the quasi-spherical member 20 (See FIG. 3C). FIG. 3Billustrates a perfect sphere 21 having a radius 23. FIG. 3C illustratesa quasi-spherical member 20 that includes an illustrative textured outersurface 11 covering essentially the entirety of the quasi-sphericalmember 20. In accordance with certain aspects of the present disclosure,quasi-spherical members or other male-type connectors in accordance withthe present disclosure will incorporate a textured outer surfacecovering more than 50%, or more than 65%, or more than 75%, or more than85% of the quasi-spherical member or another connector. In someinstances, the textured outer surface will cover between about 25% andabout 50% of the quasi-spherical member or another connector, or betweenabout 35% and about 75%, or between about 50% and about 90%, or betweenabout 60% and about 100%.

Continuing with FIG. 3C, this particular textured outer surface 11incorporates a tessellation pattern 80 that can be three-dimensional. Asuitable tessellation can incorporate a plurality of polygonal elementssuch as polygonal elements 78. In this particular instance, thepolygonal elements are triangular elements or faces 81. Textured outersurfaces according to additional aspects of the present disclosure canincorporate other suitable three-dimensional tessellations. In certainembodiments, quasi-spherical members or other male-type connectors inaccordance with the present disclosure will mimic or approximate aplurality of stacked polyhedra such as but not limited to stacked cubes,rhombic dodecahedrons, truncated octahedrons, hexagonal prisms, ortriangular prisms. In some forms, quasi-spherical members or othermale-type connectors in accordance with the present disclosure willmimic or approximate a honeycomb of polyhedral cells including uniformand non-uniform honeycombs.

Continuing with FIG. 3C, the textured outer surface 11 includes aplurality of outermost extensions 12 which in this illustrativeembodiment occur at vertices of the triangular faces as discussedhereinbelow. A distance from the center of the quasi-spherical member 20to an outermost extension 12 can be equal to the first radius 45. Whilenot necessary, an arc connecting at least two of the outermost extension12 can generally have the same curvature as the arc of the perfectsphere 21. The textured outer surface 11 includes a plurality ofinnermost depressions 13 which in this illustrative embodiment occur atthe centers of the triangular faces as discussed hereinbelow. A distancefrom the center of the quasi-spherical member 20 to an innermostdepression 13 can be equal to the second radius 46. While not necessary,an arc connecting at least two of the innermost depressions cangenerally have the same curvature as the arc of the perfect sphere 21. Asecure grip between the textured outer surface 11 and inner walls 44 ofthe bore can occur at one or more interfaces 22. While not necessary,the relationship between the first radius 45 and the second radius 46can be as follows: where R=a radius 23 of a perfect sphere 21, the firstradius 45=R+t and the second radius 46=R−t where “t” is a variable thatcan be changed to create a broad range of textured outer surfaces 11.

FIGS. 4A-D illustrate a spectrum of densities of tessellation patterns80. FIG. 4A provides a quasi-spherical member 20 with a low density 28of polygonal elements 78. FIG. 4D provides a quasi-spherical member 20with a high density 27 of polygonal elements 78. FIGS. 4B-4C illustratequasi-spherical members 20 with lower and higher intermediate densities29 of polygonal elements 78. A quasi-spherical member 20 with a higherdensity will allow a higher quality of spherical mapping. As thequasi-spherical member 20 is being adjusted in the walls 44 of the bore43 (see FIGS. 1A-B), the higher quality mapping can allow a greaterspectrum of possible orientations or angular positions of the humeralhead member 40 in relation to the quasi-spherical member 20.

FIG. 4A shows features of the polygonal elements 78. An individualpolygon 86 can have an exterior face 87 that forms an outer surface onthe quasi-spherical member 20. The exterior face 87 can include a chord89 as an edge of the exterior face 87. Each chord 89 can be contiguouswith a chord 89 of a neighboring polygon 79. The chord 89 can terminateat each end in a vertex 88. Each vertex 88 of a polygon 86 can becontiguous with a vertex 88 of a neighboring polygon 79. Any number ofthese exterior surface features (e.g., edges, chords, planar ornon-planar faces, vertices, etc.) and/or any of the other exteriorsurface features disclosed herein that can be incorporated into atextured outer surface of a male-type connecting members can forciblycontact walls or surfaces in a female-type bore to some degree, and insome instances, can be formed with materials that cause such surfacefeatures to be crushed or to otherwise deform upon such forciblecontact, to removeably lock or help to removeably lock the male-typeconnecting member in the bore. Just to give one illustrative example, aplurality of planar or nearly planar faces on a textured outer surfaceof a male-type connecting member (e.g., a quasi-spherical member) caneach partially contact a curved wall of a female bore (e.g., cylindricalor conical).

In accordance with certain aspects of the present disclosure,quasi-spherical members or other male-type connectors in accordance withthe present disclosure will incorporate a textured outer surface thatincludes a plurality of generally planar surfaces, for example, wherethe combined area of the generally planar surfaces cover more than 50%,or more than 65%, or more than 75%, or more than 85% of thequasi-spherical member or another male-type connecting member. In someinstances, the combined area of the generally planar surfaces will coverbetween about 25% and about 50% of the quasi-spherical member or othermale-type connecting member, or between about 35% and about 75%, orbetween about 50% and about 90%, or between about 60% and about 100%.

Referring now to FIG. 5A, shown is a quasi-spherical member 20 accordingto another embodiment of the present disclosure that could beincorporated into any suitable orthopedic system or implant. On whatwould otherwise be a perfect sphere, a textured outer surface 11 in thisinstance includes a plurality of planar, circular faces 82 which arespaced from one another on the quasi-spherical member. These types ofplanar faces can have any suitable perimeter shape, e.g., incorporatingrectilinear and/or curvilinear features. Illustratively, in additionalembodiments, a textured outer surface will include a plurality of planarsurfaces that are non-circular, e.g., polygonal. One example of this isthe tessellated surface pattern shown in FIG. 3C. Additionally, it willbe understood that when a textured outer surface in accordance with thepresent disclosure incorporates circular and/or non-circular exteriorfaces, such faces need not be planar. Illustratively, in additionalembodiments, a textured outer surface will include a plurality ofnon-planar surface elements that are spaced from one another on thequasi-spherical member or another male-type connecting member. Suchsurface elements can be convex or concave or can incorporate otherthree-dimensionally curved surfaces. For example, one or more of theplanar, circular faces 82 shown in FIG. 5A could instead be slightlyconvex or slightly concave. Additionally, it will be understood that anytwo such circular or non-circular surface elements need not be spacedfrom one another on a textured outer surface of a male-type connectingmember. Select surface elements can be contiguous with one another orotherwise contact one another on the textured outer surface. FIG. 5Bshows a quasi-ellipsoid member 85 according to one embodiment of thepresent disclosure that could be incorporated into any suitableorthopedic system or implant. A textured outer surface 11 in thisinstance includes a plurality of surface elements “X” which can be anyof those disclosed herein, e.g., planar and/or non-planar surfaceelements. For example, any one surface element “X” can be a bump, bulge,lump, knob, protuberance, dimple, depression, dent, or another type ofprojection or indentation. Such features can be arranged in regular orirregular patterns. These and other surface textures disclosed hereincan be formed in any suitable manner including by cutting away, grindingaway or otherwise removing material from an initial workpiece to provideone or more surface features or elements, or by welding, adhering orotherwise adding material to an existing piece to provide one or moresurface features or elements, or by casting or otherwise initiallyforming a component (e.g., using an additive manufacturing process) tohave one or more surface features or elements.

FIGS. 6A-B illustrate variations between the flatness of the surface ofeach exterior face 87 of each polygonal element 78. FIG. 6A shows aquasi-spherical member 20 having polygons 86 that have planar faces 93.FIG. 6B shows a quasi-spherical member 20 having polygons 86 that havearcuate faces 92. The arcuate face 92 can be formed with curves having avery slight radius or formed with curves having a more pronounced radiusas discussed elsewhere herein.

FIGS. 7A-B represent two configurations of an assembly 9 that includes afixation member 60 and a quasi-spherical member 20. In FIG. 7A theassembly 9 includes at least two separate pieces. The quasi-sphericalmember 20 can include a connecting member 37 that is unitarily formedwith the quasi-spherical member, or alternatively, the connecting membercan be a separately-formed piece that is subsequently connected to thequasi-spherical member using any suitable type of connection such as atapered fit or threaded connection. For example, the quasi-sphericalmember can include a female-type bore into which a male-type element ofthe connecting member is received to make a connection. Also, thefixation member 60 can include a stem cavity 76 which can receive adistal end 61 of the connecting member 37 for making a connectionbetween the two in any suitable fashion. For example, the connectionbetween the connecting member 37 and the fixation member 60 can be inany of the forms disclosed herein including in the form of a lockingtaper connection, a screw connection, a bolt connection, or a connectionemploying additional fasteners to facilitate making the connection. Forexample, the connecting member can have threads to mate with threads inthe stem cavity 76. A configuration such as illustrated in FIG. 7A canallow the mixing and matching of various forms of quasi-sphericalmember/connecting member assemblies with various forms of connectingmembers and/or fixation members 60 so that a particular patient'smorphology can be matched completely.

FIG. 7B illustrates an example of a monoblock assembly 69 in which theconnecting member 37 is not removable from the fixation member. Theseexamples should not be construed as limiting. For example, theconnecting member 37 of FIG. 7A could be integrally formed with thefixation member 60 instead of integrally formed with the quasi-sphericalmember 20. In such a case, the quasi-spherical member 20 would have acavity to receive a proximal end of the connecting member 37. It is alsopossible that the fixation member 60 and the quasi-spherical member 20and any potential intermediate member be formed as a monoblock orotherwise formed together as a single unit.

FIG. 8 illustrates an example of a humeral member or assembly 9 thatincludes a stemless member 62. The stemless member 62 could include whatis considered a short stem but in any event is not inserted deep intothe canal 73 of the humerus 74 and instead is anchored to more proximalportions of a humerus 74 (see FIG. 1C). While not necessary, thestemless member 62 can be connected to a distal end of a connectingmember 37, which in turn can be connected at its opposite end to aquasi-spherical member 20.

As discussed elsewhere herein, in some preferred forms, a textured outersurface of a male-type connector will exhibit or occupy only a portionof a particular shape such as a part of a sphere, part of an ellipsoid,etc. FIG. 9 shows a humeral member or assembly 9 according to oneembodiment of the present disclosure. Assembly 9 can include a fixationmember 60 and a male-type connector 100. A portion of the connector isshown in phantom as indicated by dashed line 101, and in this regard, itwill be understood that connector 100 can have spherical orpartial-spherical qualities. For example, in some forms, connector 100will be a truncated sphere where an illustrative segment 102 of thesphere is removed or never exists as part of the connector. While thedegree or amount of truncation shown in FIG. 9 may be useful in certainembodiments, it is merely illustrative of those contemplated. In thistruncated version of the connector, segment 102 is defined along asingle plane to create a proximal planar surface 103. When present, sucha proximal surface can be planar or non-planar. Also, any suitableportion or percentage of such a truncated or another partial shape canbe covered by a textured outer surface.

As also discussed elsewhere herein, quasi-spherical members or othermale-type connectors in accordance with certain aspects of the presentdisclosure can incorporate a textured outer surface covering only acertain portion or percentage (e.g., between about 50% and about 90%) ofthe quasi-spherical member or another connector. Continuing with FIG. 9,in some other forms, one or more connector segments or other connectorportions such as segment 102 will be part of the connector but will bevoid of a textured outer surface such as surface 99 or will have alesser-textured, differently-textured, etc. outer surface. For example,the illustrative segment 102, when present, can have a generally smoothouter surface. In this regard, while the amount or percentage ofcoverage by the textured outer surface 99 shown in FIG. 9 may be usefulin certain embodiments, it is merely illustrative of those contemplated.Any suitable degree or percentage of coverage by a particular texturedouter surface is contemplated, e.g., more than 50%, or more than 65%, ormore than 75%, or more than 85%, or between about 25% and about 50%, orbetween about 35% and about 75%, or between about 50% and about 90%, orbetween about 60% and about 100% of the quasi-spherical member or otherconnector.

In some embodiments, a quasi-spherical member or another male-typeconnector in accordance with the present disclosure is incorporated intoan orthopedic product that is to be driven into or otherwise received inbone, for example, as a product for attaching or securing anotherorthopedic device such as a bone plate or implant to bone. In some ofthese embodiments, the orthopedic product is a bone screw, for example,where a quasi-spherical member or other male-type connector is disposedat a location along the length of the screw such as at a locationbetween the ends of the screw or at or near the end of a screw to formall or part of a screw head. Such products can be formed with anysuitable material(s), and in some instances, will include an exteriorsurface that encourages bone ongrowth or ingrowth, for example,including a blasted surface to encourage bone ongrowth.

With reference now to FIG. 10, shown is a bone screw 120 that includes aquasi-spherical member 121 disposed at a proximal end 122 of the screwto provide a screw head 123. In this particular embodiment, a femalebore 125 with a hexagonal cross-section extends into the head from aproximal surface 126 of the head. Bone screw 120 also includes a shaft128. While this sort of a quasi-spherical bone screw head can be pairedwith a bone screw shaft of any suitable size, shape or configuration, inthis particular instance, the shaft extends distally from the proximalend 122 (e.g., head of the screw) to a leading, distal tip 130 of thescrew. A central cannula 131 continues on from female bore 125 andtraverses the entire length of the screw which can be useful, forexample, for placing the screw over a positioned K-wire. Bone screws andfasteners in accordance with the present disclosure can be fully orpartially cannulated or non-cannulated. Cannulated regions can have anysuitable wall thickness.

Continuing with FIG. 10, shaft 128 includes a proximal section 133having a first diameter and a distal section 134 having a seconddiameter that is smaller than the first diameter. Bone screw andfastener shafts in accordance with the present disclosure can haveconstant diameters or cross-sections along their lengths, or a shaftdiameter or cross-section can vary along its length. For example, anysection of a shaft can be tapered or non-tapered. Thus, proximal section133 and/or distal section 134 can be fully or partially tapered alongits length. While not necessary to broader aspects of the disclosure, adual- or other multi-diameter or cross-section shaft can be useful in avariety of instances, for example, where shaft sections with differentdiameters or cross sections are intended to reside in different types orareas of bone. For example, when bone screw 120 is placed in a glenoid,this sort of dual-diameter arrangement can account for the smallervolume of bone or a minimum cross-section of the bone anatomy (e.g.blade of scapula) located away from the point of entry of the screw aswell as the comparatively larger volume of available bone located closerto the entry point (e.g. glenoid vault). In this regard, proximalsection 133 can be considered a glenoid vault zone, and distal section134 can be considered a glenoid blade zone of screw 120 if the screwhappens to be placed in this particular anatomy.

Continuing with FIG. 10, threading 135 (not shown for clarity reasons)which can have a consistent screw pitch extends along both the proximaland distal sections of the shaft. Bone screws and fastener shafts inaccordance with the present disclosure can be fully or partiallythreaded or non-threaded. Any suitable threading can be employed, and ascrew or fastener can have different types of threading at differentlocations along a shaft. Above are just a few non-limiting examples ofhow a quasi-spherical member or another male-type connector inaccordance with the present disclosure can be paired with a shaft of anysuitable size, shape or configuration including self-drilling orself-tapping shafts.

A quasi-spherical member or another male-type connecting member of abone screw or other fastening-type device in accordance with the presentdisclosure can be used with (e.g., received and locked in a bore presentin) any number of implants or other orthopedic devices disclosedelsewhere herein. These include plates (e.g., bone plates) and othernon-plate orthopedic devices. One or more bone screws or otherfastening-type devices in accordance with the present disclosure can beutilized in any one device. FIG. 11 is illustrative of one such deviceand shows, for example, how different angular positions X and Y can beachieved and maintained using connections according to aspects of thepresent disclosure. In particular, FIG. 11 depicts an orthopedicassembly 140 that includes an orthopedic device 141 (e.g., a bone plateor implant) that provides a first tapered female bore 142 and a second,identical tapered female bore 143 with walls 144. These particular boreshave a shape of a frustum of a right circular cone. Although notnecessary to broader aspects of the disclosure, the bores each extendentirely through a wall or section 145 of the device. Either bore couldhave any suitable size and shape. As disclosed elsewhere herein, asuitable female bore can be tapered or non-tapered and can otherwise beor incorporate any suitable three-dimensional shape, e.g., incorporatingrectilinear and/or curvilinear features. Continuing with FIG. 11,assembly 140 also includes a first bone screw 146 and an identicalsecond bone screw 147. Each screw includes a quasi-spherical head 148and a shaft 149 extending from the head. These heads and shafts could beany combination of heads and shafts disclosed herein. In use, theleading ends of the shafts can be passed into and through the bores. Inthe FIG. 11 illustration, this passing occurs in a downward direction,i.e., the leading ends enter the frustoconical bores through the largertop ends of the bores and exit the smaller bottom ends. Thereafter, thescrews can be advanced (e.g., into bone) until the quasi-spherical headsare received down into the respective female bores and locked therein togenerate the different angular positions X and Y. Based on the FIG. 11orientation, seating can also be fully or partially accomplished bymoving the bores in an upward direction relative to the heads. Althoughnot necessary to broader aspects of the disclosure, the walls of thebores extend fully around the seated heads, e.g., with no breaks oropenings in the walls that form the frustoconical bore shapes.

FIG. 12 shows a front view of an orthopedic assembly according toanother embodiment of the present disclosure, and shows, for example,how different angular positions X and Y can be achieved and maintainedusing connections according to aspects of the present disclosure. Inparticular, FIG. 12 depicts an orthopedic assembly 140 that includes anorthopedic device 141 (e.g., a bone plate or implant) that provides afirst tapered female bore 142′ and a second, identical tapered femalebore 143′ with walls 144′. These particular bores have a shape of afrustum of a tight circular cone. Although not necessary to broaderaspects of the disclosure, the bores each extend entirely through a wallor section 145 of the device. Either bore could have any suitable sizeand shape. As disclosed elsewhere herein, a suitable female bore can betapered or non-tapered and can otherwise be or incorporate any suitablethree-dimensional shape, e.g., incorporating rectilinear and/orcurvilinear features. Such bores could extend only partially through thewall or section, for example, as shown with the elongated bore oropening in FIG. 13C. Continuing with FIG. 12, assembly 140 also includesa first bone screw 146 and an identical second bone screw 147. Eachscrew includes a quasi-spherical head 148 and a shaft 149 extending fromthe head. These heads and shafts could be any combination of thosedisclosed herein. In use, the quasi-spherical heads can be received andlocked in the respective female bores to generate the different angularpositions X and Y. Based on the FIG. 12 illustration, such connectionscan be achieved by moving wall or section 145 in a downward directiononto the screws (e.g., by impacting the device 141) so that the headsenter the frustoconical bores through the larger bottom ends of thebores and move a distance in the bores toward the smaller top ends untilsuitably locked in place. Based on the FIG. 12 orientation, seating canalso be fully or partially accomplished by moving quasi-spherical heads148 in an upward direction relative to the bores. In this regard,depending on the sizes and shapes of the various components, it ispossible to make the connections with no portions of the shafts everentering the bores. Although not necessary to broader aspects of thedisclosure, the walls of the bores extend fully around the seated heads,e.g., with no breaks or openings in the walls that form thefrustoconical bore shapes. In some forms, a screw will be advanced to adesired final location in a bone before a quasi-spherical screw head islocked in a female bore of a device, for example, where a plate isimpacted down onto a pre-positioned screw so that the quasi-sphericalmember is forcefully received and locked in the female bore.

Turning now to FIG. 13A, shown is a top view of an orthopedic plate 200according to one embodiment of the present disclosure. From this view,plate 200 is shown to include a generally rectangular bore or opening201. Although not necessary to broader aspects of the disclosure, therectangular opening extends entirely through the plate, i.e., in adirection into the page based on the FIG. 13A illustration. Such anopening can be an elongated or slot-type opening of any suitable sizeand rectangular or non-rectangular shape. A plate or other device canincorporate any number of such openings. Illustratively, such an openingcan have one dimension (e.g., rectangular slot length when viewed fromthe top as in FIG. 13A) that is significantly larger than anotherdimension (e.g., rectangular slot width) including but not limited to afirst dimension that is 2 to 40, or 4 to 20, or 8 to 15 times largerthan a second dimension. An elongated or slot-type opening can have acurvature along its length, for example, even providing in someembodiments an annular or ring-shaped slot with no ends. Also, althoughthe width of the opening 201 in FIG. 13A is constant along its length,it need not be. Such a slot can be a series of discernable openings orbores like those shown in FIGS. 11 and 12 which are interconnectedacross a plate or other device, for example, interconnected by slots orpassages of a smaller width or dimension that allow interbore movementof another assembly component such as horizontal movement of a screw orfastener shaft from one bore to another along a plate or other devicebefore the screw or fastener is ultimately locked in place in aparticular bore. Any such elongated or slot-type opening can be part ofany plate or non-plate orthopedic device in accordance with the presentdisclosure.

FIG. 13B shows a cross-sectional view taken along view line 13B-13B fromFIG. 13A, and it can be seen that walls 202 of the opening are angled ortapered. Based on the FIG. 13B orientation, the walls diverge movingfrom top to bottom so that the top end of the opening 201 is smallerthan the bottom end of the opening. Based on the FIG. 13B illustration,a connection with a quasi-spherical member or another male-typeconnector in accordance with the present disclosure can be achieved bymoving plate 200 in a downward direction onto the quasi-spherical member(e.g., which forms all or part of a screw head) so that thequasi-spherical member enters the opening through the larger bottom endof the opening and moves a distance in the opening toward the smallertop end until suitably locked in place. Alternatively, the plate couldbe flipped over from what is shown in FIG. 13B, and a leading tip of ascrew could be passed into and through the opening, and the screw couldbe advanced until a quasi-spherical head of the screw is locked into theopening.

That such openings can have an elongated or slot-type shape allows aquasi-spherical member such as that of the screw shown in FIG. 10, priorto being locked in place, to be moved to different relative positionsalong the length of a slot or other opening. For example, when viewingthe FIG. 13A illustration, such a quasi-spherical member could bereceived and locked in place in the opening at or near one end of theopening, at or near the far opposite end of the opening, or anywhere inbetween. Although not necessary to broader aspects of the disclosure, atopposite ends of the rectangular opening, the opening 201 is tapered onthree sides. Alternatively, the illustration of FIG. 13B can representone end of plate 200 such that it is not a cross-sectional view of plate200 but rather an end view. In this regard, a quasi-spherical membercould be partially and loosely received in the opening, and the platecould be slid over a quasi-spherical member (e.g., from the side) beforea connection is made. Such a configuration could be particularly useful,for example, where space is limited anatomically such as where it is noteasy or possible to introduce a plate or device other than from theside. Such side openings could be located anywhere on a plate or otherdevice.

FIG. 13C shows part of an orthopedic plate 210 according to anotherembodiment of the present disclosure. Plate 210 includes a top surface211 and bottom surface 212. This plate is similar to that shown in FIG.13B except that it includes an opening 213 which extends only partiallythrough the plate, and in this regard, FIG. 13C represents across-sectional view of the plate taken from a similar vantage point asthe cross-sectional view in FIG. 13B. In particular, opening 213 extendsinto the plate from bottom surface 212, and walls 214 of the openingconverge moving toward the top surface 211 of the plate. Alternatively,the illustration of FIG. 13C can represent one or both ends of plate 210such that it is not a cross-sectional view of plate 210 but rather anend view. In this regard, a quasi-spherical member could be partiallyand loosely received in the opening, and the plate could be slid over aquasi-spherical member (e.g., from the side) before a connection ismade. Such a configuration could be particularly useful, for example,where space is limited anatomically such as where it is not easy orpossible to introduce a plate or device other than from the side. Suchside openings could be located anywhere on a plate or other device.

FIG. 14 illustrates an embodiment of an implant assembly 300 for a totalshoulder joint replacement. While the implant assembly 300 isillustrated in the drawings as a reverse shoulder prosthesis, othershoulder prostheses are contemplated. The implant assembly 300 isconfigured to be implanted between a resected humerus 302 and a glenoidcavity (“glenoid”) 304 of a scapula 306 in a reverse arthroplasty. Theimplant assembly 300 can include a head member 308 (henceforth: “head”),a humeral tray assembly 310, and an adapter 311. The humeral trayassembly 310 can include a humeral tray member 312 (henceforth: “tray”)and an articulating liner member 314 (henceforth: “liner”). The implantassembly 300 may also include a fixation member 316 that has a proximalend 318 and a distal end 320.

In the embodiment shown in FIG. 14, the head 308 can be bounded by aconvex surface 322, which may be, for example, a hemispherical surface,and a base 324, which may be a substantially planar surface. In oneembodiment, the base 324 may be modularly connected to the head 308. Afemale taper 326 with tapered inner walls 328 can extend from the base324 into the head 308. The convex surface 322 of the head 308 can beshaped to articulate with a concave surface 330 of the liner 314 toallow for shoulder joint movement. Such articulation may be centered oreccentric.

In one embodiment, the adapter 311 may include an adapter tray 332 andan extension or male taper 334 that can be press-fitted into the femaletaper 326 of the head 308. For the procedure of reverse arthroplasty,the adapter tray 332 can be attached to the glenoid 304.

Referring to FIG. 14, the tray 312 can include a bottom side 336 thatcan include a tray stem 338. The tray stem 338 can be any structure thatextends from the bottom side 336 and can be configured in a variety oflengths and shapes to provide for patient anatomies of different sizesand shapes. The tray stem 338 can include any feature or any combinationof features such as described for the connecting member 37 in FIGS. 1,7, and 8. A quasi-spherical member 340 such as a quasi-spherical memberhaving any feature or any combination of features of the quasi-sphericalmembers described in FIGS. 1-13 can be coupled adjacent the distal end339 (see FIG. 15) of the tray stem 338 and can be configured to beselectively coupled to the fixation member 316 in a reverse shoulderarthroplasty, or other joint replacement procedure. The fixation member316 can extend from a distal end 320 to a proximal end 318. A bore 342can be defined in the proximal end 318. The bore 342 can be tapered andcan include all the features relating to any or any combination of thefeatures of bores 43 or 143 described above. In addition, the bore 342can include any or any combination of the features of bores 43 or 143described above as they relate to the quasi-spherical member 340.

The quasi-spherical member 340 can be located in the bore 342. An angleof the tray 312 relative to the fixation member 316 can be adjusted inthree dimensions. Once the tray 312 is deemed by a surgeon to besuitably oriented, the quasi-spherical member 340 can then be more fullyinserted into the bore 342, e.g., by impaction loading accomplished bypressure, impact force or otherwise. In some instances, forcible contactbetween a male-type member such as the quasi-spherical member 340 andwalls of the bore 342 will be sufficient to crush or to otherwise deformsurface features of the male-type member and/or surfaces or walls withinthe bore 342. The shape of the bore 342 including its walls 344 and theshape and surface features of the quasi-spherical member 340 can be suchthat the quasi-spherical member 340 can be positionable in the bore 342of the fixation member 316 for removably locking the quasi-sphericalmember 340 to the fixation member 316, e.g., providing a fixed immovableconnection between the quasi-spherical member 340 and the fixationmember 316.

In an example, surfaces of the proximal end 318 of the fixation member316 and/or the proximal end of the resected humerus 302 can be modifiedor adjusted to enable additional angular adjustment of the tray 312relative to the fixation member 316.

FIG. 15 shows a perspective view of a humeral tray assembly 310,according to at least one embodiment of the present disclosure. Thehumeral tray assembly 310 can generally include a tray 312, a liner 314,and a retaining ring 346. As will become appreciated, the retaining ring346 can be adapted to retain the liner 314 relative to the tray 312 in alocked position.

The tray 312 can include a top side 313 that can generally define a traymember cavity 348 that can form a recess configured to receive the liner314. Note: although the terms top side 313 and bottom side 336 have beenused in this description, this is for explanation purposes only and theorientation of the tray 312 can be any three-dimensional orientation,limited only in that “top side 313” and “bottom side 336” are twogenerally opposing surfaces. The tray 312 can generally include aplatform portion 350 and a tray stem 338. The platform portion 350 canhave an upper rim 352. The tray 312 can have a liner engaging surface354. The tray 312 may comprise a biocompatible metal, such as stainlesssteel, titanium, titanium alloys, and cobalt-chromium alloys. In analternative, the tray 312 can comprise any biocompatible material. Theupper rim 352 can have a first interlocking portion 356. In the exampleshown, the first interlocking portion 356 is in the form of tabs 358radially positioned around the upper rim 352. The tabs 358 can generallybe raised relative to the upper rim 352. The platform portion 350 canfurther define an inboard annular groove 360 formed around the linerengaging surface 354. The upper rim 352 can further include a first slot362. In one example, the first slot 362 can include a generally planarsurface or ledge 364 that is transverse to a long axis of the tray stem338. Fingers 366 of the retaining ring 346 can engage the first slot362. Portions of the tray 312 can include bone engaging surfaces havinga porous coating.

The liner 314 will now be described in greater detail. The liner 314 maybe formed of polyethylene or other suitable bearing material. The liner314 can generally include an outer tray engaging surface 368 and aninner head engaging surface 370. An outboard annular groove 369 can beformed around the outer tray engaging surface 368. The outer trayengaging surface 368 can have a generally planar surface, while theinner head engaging surface 370 can be generally concave. A secondinterlocking portion 372 can be formed around a rim portion 371 of theliner 314. In the example shown, the second interlocking portion 372 isin the form of complementary notches 374 defined around the rim portion371. The first and second interlocking portions 356 and 372 cancooperatively mate in an assembled position (FIG. 16), such that thetabs 358 nest with the notches 374 and, therefore, inhibit rotationalmotion of the liner 314 within the tray 312. In the particular exampleshown, the amount of notches 374 equals the amount of tabs 358. It isappreciated however, that in other examples, the notches 374 mayoutnumber the tabs 358.

The retaining ring 346 can be adapted to locate within the inboardannular groove 360 of the tray 312. In a locked position, the inboardannular groove 360 of the tray 312 is operable to snappingly receive theretaining ring 346 to secure the liner 314 to the tray 312. Explainedfurther, the retaining ring 346 can be adapted to partially nest withinthe inboard annular groove 360 of the tray 312 and, concurrently,partially nest within the outboard annular groove 369 of the liner 314in the locked position (FIG. 16). An annular protrusion 376 of theretaining ring 346 can nest within a second slot 378. In this way, theretaining ring 346 may be discouraged from rotating around the platformportion 350 of the tray 312.

The quasi-spherical member 340 can be coupled to or integral formed witha distal end 339 of the tray stem 338 (see FIG. 16).

FIG. 16 shows a cross section of a humeral tray assembly 310, accordingto at least one embodiment of the present disclosure. Thequasi-spherical member 340 can include any of the shapes, surfaces,materials, forms, qualities, and/or functions described above in FIGS.1-13. The tray 312 can define one or more recesses 380A, 380B in thebottom side 336 that can be configured to allow greater angular movementof the tray 312 relative to the fixation member 316 (see FIG. 14) whenthe desired orientation of the tray 312 is being set by a surgeon. FIG.16 shows the liner 314 installed in the tray 312 and held in place bythe retaining ring 346 in the outboard annular groove 369 and theinboard annular groove 360. The ledge 364 is shown.

The tray stem 338 can be configured in a variety of lengths to adapt thehumeral tray assembly 310 for different amounts of angular adjustment,and/or different patient anatomies.

Although the humeral tray assembly 310 has been described in detailabove, the present inventor has contemplated other forms that mayinclude different contours, subassemblies, and/or additions (e.g.,spacers), forms (e.g., one piece tray and liner assembly) withoutchanging the intent of this disclosure.

FIG. 17 shows a tray 312 engaged with a fixation member 316, accordingto at least one embodiment of the present disclosure. The fixationmember 316 can include a threaded bore 382. The tray stem 338 caninclude a stem bore 384. Portions of the stem bore 384 can be threaded,or the stem bore 384 can be unthreaded. The stem bore 384 can extendfrom the liner engaging surface 354 (see FIG. 15) to the tip 386 of thequasi-spherical member 340. If no angular adjustment of the tray 312 isrequired, a fastener (not shown) can extend through the stem bore 384into the threaded bore 382 and can attach the tray 312 to the fixationmember 316. Although the quasi-spherical member 340 is shown locatednear the bore base 390 of the bore 342, the quasi-spherical member 340can be configured to fit at other locations of the walls 344 of the bore342 (e.g., by altering the diameter of the quasi-spherical member 340and/or the bore 342). The walls 344 can be tapered, shaped, or formed inmanners described above in relation to bore 43 and/or bore 143.

FIG. 18 shows a tray 312 engaged with a fixation member 316, accordingto at least one embodiment of the present disclosure. FIG. 18 shows therelationship between the fixation member 316 and the tray 312 at a firstangle 392 and FIG. 19 shows the relationship between the fixation member316 and the tray 312 at a second angle 394. FIG. 18 shows a top edge 396that is generally in the same plane along both sides of the bore 342. InFIG. 19, the top edge 396 can be configured to be recessed, angled, orcut away, for example at portion 398 so that the second angle 394 can beincreased without interfering with the bottom side 336 of the tray 312.The tray stem 338 in FIG. 19 is shorter than the tray stem 338 of FIG.18 and the tray 312 can be provided with tray stems 338 of variouslengths to accommodate different anatomies, surgical procedures, and/orangular adjustments.

FIG. 20 shows a tray 312 engaged with a fixation member 316, accordingto at least one embodiment of the present disclosure. In an embodiment,one or both of the tray stem 338 and the quasi-spherical member 340 donot include a stem bore 384 (see FIG. 17) and can be solid material.

FIG. 21 shows a humeral tray assembly 400 having an internal bore 402,according to at least one embodiment of the present disclosure. Thehumeral tray assembly 400 can include a tray 412 and a liner 414. Thetray 412 can include an internal bore 402, having tapered walls 404 andconfigured to operate as the bore 43 described in FIGS. 1-9. Theinternal bore 402 can engage a quasi-spherical member 20 located on afixation member 60 as described in FIGS. 1-9. The humeral tray assembly400 can be angularly adjusted in the same manner as the humeral headmember 40 described above in FIGS. 1-9.

FIG. 22 shows an implant assembly for a total shoulder jointreplacement, according to at least one embodiment of the presentdisclosure.

While the implant assembly 500 is illustrated in the drawings as areverse shoulder prosthesis, other shoulder prostheses are contemplated.The implant assembly 500 is configured to be implanted between aresected humerus 502 and a glenoid cavity (“glenoid”) 504 of a scapula506 in a reverse arthroplasty. The implant assembly 500 can include ahead member 508 (henceforth: “head”), a humeral tray assembly 510, andan adapter 511. The humeral tray assembly 510 can include a humeral traymember 512 (henceforth: “tray”) and a liner member 514 (henceforth:“liner”). The implant assembly 500 may also include a fixation member516 that has a proximal end 518 and a distal end 520. The fixationmember 516 can extend from a distal end 520 to a proximal end 518. Abore 542 can be defined in the proximal end 518.

In the embodiment shown in FIG. 22, the head 508 can be bounded by aconvex surface 522, which may be, for example, a hemispherical surface,and a base 524, which may be a substantially planar surface. In oneembodiment, the base 524 may be modularly connected to the head 508. Afemale taper 526 with tapered inner walls 528 can extend from the base524 into the head 508. The female taper 526 can include all the featuresrelating to any or any combination of the features of bores 43 or 143described above. The convex surface 522 of the head 508 can be shaped toarticulate with a concave surface 530 of the liner 514 to allow forshoulder joint movement. Such articulation may be centered or eccentric.

In one embodiment, the humeral tray assembly 510 can be fixed to theresected humerus 502, by means of fasteners, adhesives, or press fit.The tray 512 can include a bottom side 536 that can include a tray stem538. The tray stem 538 can be any structure that extends from the bottomside 536 and can be configured in a variety of lengths and shapes toprovide for patient anatomies of different sizes and shapes. The traystem 538 can include any feature or any combination of features such asdescribed for the connecting member 37 in FIGS. 1, 7, and 8. The traystem 538 can be bonded, press fit, or fastened into a bore 542 that canbe defined in the proximal end 518. The bore 542 can be tapered and caninclude all the features relating to any or any combination of thefeatures of bores 43 or 143 described above.

In one embodiment, the adapter 511 may include an adapter tray 532. Theadapter tray 532 can include an adapter stem 535. The adapter stem 535can be configured as any structure that extends from the adapter tray532 and can be configured in a variety of lengths and shapes to providefor patient anatomies of different sizes and shapes. For the procedureof reverse arthroplasty, the adapter tray 532 can be attached to theglenoid 504.

A quasi-spherical member 540 such as a quasi-spherical member having anyfeature or any combination of features of the quasi-spherical membersdescribed in FIGS. 1-13 can be coupled adjacent a distal end of theadapter stem 535 and can be configured to be selectively coupled to thehead 508 in a reverse shoulder arthroplasty, or other joint replacementprocedure.

The quasi-spherical member 540 can be located in the female taper 526.An angle of the head 508 relative to the adapter 511 can be adjusted inthree dimensions. Once the head 508 is deemed by a surgeon to besuitably oriented, the quasi-spherical member 540 can then be more fullyinserted into the female taper 526, e.g., by impaction loadingaccomplished by pressure, impact force or otherwise. In some instances,forcible contact between a male-type member such as the quasi-sphericalmember 540 and walls of the female taper 526 will be sufficient to crushor to otherwise deform surface features of the male-type member and/orsurfaces or walls within the female taper 526. The shape of the femaletaper 526 including its tapered inner walls 528 and the shape andsurface features of the quasi-spherical member 540 can be such that thequasi-spherical member 540 can be positionable in the female taper 526of the head 508 for removably locking the quasi-spherical member 540 tothe head 508, e.g., providing a fixed, immovable connection between thequasi-spherical member 540 and the fixation head 508.

In an example, surfaces of the glenoid cavity 504 can be modified oradjusted to enable additional angular adjustment of the adapter 511relative to the head 508.

FIGS. 23-26 illustrate examples of an implant assembly 600 for a totalshoulder joint replacement, according to at least one embodiment of thepresent disclosure. While the implant assembly 600 is illustrated inFIGS. 23-26 as a reverse shoulder prosthesis, other shoulder prosthesesare contemplated, and the devices/methods illustrated that include morethan one quasi-spherical member can be used in other joint replacementapplications and other angularly adjustable fastening applications.

The implant assembly 600 shown in FIGS. 23-26 can be similar to theimplant assembly 500 described above in conjunction with FIG. 22. FIG.23 illustrates the implant assembly 600 that can include a head 608, anadapter, 611, an adapter tray 632, an adapter stem 635 and aquasi-spherical member 640. The head 608 can define a female taper 626that can include tapered inner walls 628. The quasi-spherical member 640can include any or any combination of the features of quasi-sphericalmembers described above. In addition, the quasi-spherical member 640 candefine a tip taper 641 which can extend from an outer surface of thequasi-spherical member 640 towards the adapter stem 635.

The implant assembly 600 can include a secondary locking system 699 thatcan allow a secondary securement of the head 608 to the quasi-sphericalmember 640. The secondary locking system 699 can include a head 608having a pin bore 650 that extends from a convex surface 622 to thefemale taper 626. The pin bore 650 can include a lip 651 that can narrowa portion of the pin bore 650. The secondary locking system 699 caninclude a locking pin 652. The locking pin 652 can include a pin base653. A pin stem 654 can extend from the pin base 653 and can include apin quasi-spherical member 655 opposite the pin base 653. The pinquasi-spherical member 655 can include any or any combination of thefeatures of quasi-spherical members described above.

The locking pin 652 can be configured to pass at least partially throughthe pin bore 650. The lip 651 can form a shoulder to prevent the pinbase 653 from passing through the pin bore 650 and the pin base 653 canrest against the lip 651 as shown in FIG. 25.

As shown in FIG. 24, the head 608 can be located on the quasi-sphericalmember 640. As described above, the head 608 can be angularly adjusted,and when an angle is accomplished the head 608 can be impacted so thatthe female taper 626 and the quasi-spherical member 640 are joined in amanner that keeps the head securely at the desired placement angle. Asshown in FIG. 24, the pin bore 650 can generally align with the tiptaper 641. At least portions of the diameter of the pin bore 650 can begreater than the diameter of the tip taper 641. Having a greaterdiameter of the pin bore 650 can allow the pin quasi-spherical head 655to be located within the tip taper 641 when the head 608 has beenadjusted to the desired placement angle.

FIG. 25 illustrates the locking pin 652 installed in the pin bore 650.The pin quasi-spherical member 655 can be located in the tip taper 641.The connection between the pin quasi-spherical member 655 and the tiptaper 641 can include any of the features of the connections describedabove with tapered bores and quasi-spherical members. In an example, thelocking pin 652 can be installed into the tip taper 641 before the head608 has been impacted and locked onto the quasi-spherical member 640. Inan example, the locking pin 652 can be installed into the tip taper 641after the head 608 has been impacted and locked onto the quasi-sphericalmember 640.

FIG. 26 illustrates an implant assembly 600 in which the head 608 hasbeen adjusted so that a base 624 can form an angle 656 with the adaptertray 632. When a desired angle 656 or location of the head 608 relativeto the adapter tray 632 has been found, the pin quasi-spherical member655 can be locked into the tip taper 641 by impaction loadingaccomplished by pressure, impact force or otherwise as described above.The pin quasi-spherical member 655 of the locking pin 652 can provide aholding force that can complement or take the place of the holding forceprovided by the quasi-spherical member 640.

The above-detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention can be practiced. These embodiments are also referred toherein as “examples.” Such examples can include elements in addition tothose shown or described. However, the present inventors alsocontemplate examples in which only those elements shown or described areprovided. Moreover, the present inventors also contemplate examplesusing any combination or permutation of those elements shown ordescribed (or one or more aspects thereof), either with respect to aparticular example (or one or more aspects thereof), or with respect toother examples (or one or more aspects thereof) shown or describedherein.

In the event of inconsistent usages between this document and anydocuments so incorporated by reference, the usage in this documentcontrols.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a non-exclusive or, suchthat “A or B” includes “A but not B,” “B but not A,” and “A and B,”unless otherwise indicated. In this document, the terms “including” and“in which” are used as the plain-English equivalents of the respectiveterms “comprising” and “wherein.” Also, in the following claims, theterms “including” and “comprising” are open-ended, that is, a system,device, article, composition, formulation, or process that includeselements in addition to those listed after such a term in a claim arestill deemed to fall within the scope of that claim. Moreover, in thefollowing claims, the terms “first,” “second,” and “third,” etc. areused merely as labels, and are not intended to impose numericalrequirements on their objects.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherembodiments can be used, such as by one of ordinary skill in the artupon reviewing the above description. The Abstract is provided to complywith 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims. Also, in the above Detailed Description,various features may be grouped together to streamline the disclosure.This should not be interpreted as intending that an unclaimed disclosedfeature is essential to any claim. Rather, inventive subject matter maylie in less than all features of a particular disclosed embodiment.Thus, the following claims are hereby incorporated into the DetailedDescription as examples or embodiments, with each claim standing on itsown as a separate embodiment, and it is contemplated that suchembodiments can be combined with each other in various combinations orpermutations. The scope of the invention should be determined withreference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

What is clamed is:
 1. An implant assembly for use in a reverse totalshoulder arthroplasty, comprising: a tray member that includes a topside and a bottom side, the top side defining a tray member cavity, thebottom side including a tray stem; a fixation member anchorable to ahumerus bone of a patient, the fixation member having a distal end and aproximal end, the fixation member including an opening into a bore thatextends into the fixation member from said proximal end toward saiddistal end; and a quasi-spherical member disposed adjacent a distal endof the tray stem, the quasi-spherical member positionable in the bore ofthe fixation member for removably locking the quasi-spherical member tothe fixation member, wherein the quasi-spherical member includes atextured outer surface for contacting walls of the bore.
 2. The implantassembly of claim 1, further comprising an articulating liner, thearticulating liner including a first end that is receivable in said traymember cavity for axially securing said articulating liner to said traymember, wherein the articulating liner is configured for articulatingwith surfaces of a ball member.
 3. The implant assembly of claim 1,wherein the bore includes a tapered segment.
 4. The implant assembly ofclaim 1, wherein the textured outer surface covers more than 50% of thequasi-spherical member.
 5. The implant assembly of claim 1, wherein thetextured outer surface includes a plurality of generally planar faces.6. The implant assembly of claim 5, wherein the plurality of generallyplanar faces are spaced from one another on the quasi-spherical member.7. The implant assembly of claim 5, wherein the plurality of generallyplanar faces are contiguous with one another on the quasi-sphericalmember.
 8. The implant assembly of claim 5, wherein the plurality ofgenerally planar faces have curvilinear perimeters.
 9. The implantassembly of claim 8, wherein the plurality of generally planar faceshave circular perimeters.
 10. The implant assembly of claim 5, whereinthe plurality of generally planar faces have rectilinear perimeters. 11.The implant assembly of claim 10, wherein the plurality of generallyplanar faces have polygonal perimeters.
 12. The implant assembly ofclaim 11, wherein the plurality of generally planar faces havetriangular perimeters.
 13. The implant assembly of claim 1, wherein thetextured outer surface includes a plurality of surface elements withpolygonal perimeters.
 14. The implant assembly of claim 13, wherein theplurality of surface elements are planar within the polygonalperimeters.
 15. The implant assembly of claim 13, wherein the pluralityof surface elements are convex or concave within the polygonalperimeters.
 16. The implant assembly of claim 1, wherein the texturedouter surface includes a three-dimensional tessellation incorporatingpolygonal surfaces.
 17. The implant assembly of claim 1, wherein thequasi-spherical member approximates a honeycomb of polyhedral cells. 18.The implant assembly of claim 1, wherein the textured outer surfaceincludes a plurality of outermost extensions spaced from one another onthe textured outer surface and defining a first radius of thequasi-spherical member and a plurality of innermost depressions spacedfrom one another on the textured outer surface and defining a secondradius of the quasi-spherical member.
 19. The implant assembly of claim18, wherein the bore includes a tapered segment with a first diameterthat is twice the first radius and a second diameter that is twice thesecond radius.
 20. The implant assembly of claim 18, wherein saidplurality of innermost depressions occur on planar surfaces on thequasi-spherical member.